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First Name:
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Last Name:
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Email Address:
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Company/organization name
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Please describe how your job and/or company has been impacted by the COVID-19 pandemic:
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Any additional information you want to share:
Permission to use information
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By checking this box you grant E4TheFuture permission to share your response with your elected representatives in Congress. E4TheFuture reserves the right to edit responses to improve clarity without altering your story’s substance. E4TheFuture will reach out directly to you if we decide to use your responses in social media posts, press releases, or publications.